The Maudsley Prescribing Guidelines in Psychiatry (häftad)
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13th Edition
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The Maudsley Prescribing Guidelines in Psychiatry (häftad)

The Maudsley Prescribing Guidelines in Psychiatry

Häftad Engelska, 2018-05-18
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The revised 13th edition of the essential reference for the prescribing of drugs for patients with mental health disorders The revised and updated 13th edition of The Maudsley Prescribing Guidelines in Psychiatry provides up-to-date information, expert guidance on prescribing practice in mental health, including drug choice, treatment of adverse effects and how to augment or switch medications. The text covers a wide range of topics including pharmacological interventions for schizophrenia, bipolar disorder, depression and anxiety, and many other less common conditions. There is advice on prescribing in children and adolescents, in substance misuse and in special patient groups. This world-renowned guide has been written in concise terms by an expert team of psychiatrists and specialist pharmacists. The Guidelines help with complex prescribing problems and include information on prescribing psychotropic medications outside their licensed indications as well as potential interactions with other medications and substances such as alcohol, tobacco and caffeine. In addition, each of the book's 165 sections features a full reference list so that evidence on which guidance is based can be readily accessed. This important text: Is the world's leading clinical resource for evidence-based prescribing in day-to-day clinical practice and for formulating prescribing policy Includes referenced information on topics such as transferring from one medication to another, prescribing psychotropic medications during pregnancy or breastfeeding, and treating patients with comorbid physical conditions, including impaired renal or hepatic function. Presents guidance on complex clinical problems that may not be encountered routinely Written for psychiatrists, neuropharmacologists, pharmacists and clinical psychologists as well as nurses and medical trainees, The Maudsley Prescribing Guidelines in Psychiatry are the established reference source for ensuring the safe and effective use of medications for patients presenting with mental health problems.
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David M. Taylor BSc, MSc, PhD, FFRPS, FRPharmS, is Director of Pharmacy and Pathology at the Maudsley Hospital and Professor of Psychopharmacology at King's College, London. Thomas R. E. Barnes, MBBS, MD, FRCPsych, DSc, is Emeritus Professor of Clinical Psychiatry at Imperial College London and joint-head of the Prescribing Observatory for Mental Health at the Royal College of Psychiatrists' Centre for Quality Improvement. Allan H. Young, MB, ChB, MPhil, PhD, FRCPC, FRCPsych, is Chair of Mood Disorders and is Director of the Centre for Affective Disorders in the Department of Psychological Medicine in the Institute of Psychiatry at King's College London, UK.


Preface x Acknowledgements xii Notes on using The Maudsley Prescribing Guidelines in Psychiatry xiii List of abbreviations xv Part 1 Drug treatment of major psychiatric conditions 1 Chapter 1 Schizophrenia and related psychoses 3 ANTIPSYCHOTIC DRUGS 3 General introduction 3 General principles of prescribing 8 Minimum effective doses 9 Licensed maximum doses 12 Equivalent doses 14 High?dose antipsychotics: prescribing and monitoring 16 Combined antipsychotics 20 Antipsychotic prophylaxis 25 Negative symptoms 31 Monitoring 36 Relative adverse effects - a rough guide 39 Treatment algorithms for schizophrenia 40 First?generation antipsychotics - place in therapy 44 NICE guidelines for the treatment of schizophrenia 46 Antipsychotic response - to increase the dose, to switch, to add or just wait - what is the right move? 49 Acutely disturbed or violent behaviour 54 Antipsychotic depots/long?acting injections (LAIs) 66 Depot/LAI antipsychotics - pharmacokinetics 71 Management of patients on long?term depots/LAIs 73 Aripiprazole long?acting injection 75 Olanzapine long?acting injection 77 Paliperidone palmitate long?acting injection 79 Risperidone long?acting injection 82 Electroconvulsive therapy and psychosis 86 Omega?3 fatty acid (fish oils) in schizophrenia 88 ANTIPSYCHOTIC ADVERSE EFFECTS 90 Extrapyramidal symptoms 90 Akathisia 94 Weight gain 97 Treatment of antipsychotic?induced weight gain 99 Neuroleptic malignant syndrome 104 Catatonia 107 ECG changes - QT prolongation 112 Effect of antipsychotic medications on plasma lipids 119 Diabetes and impaired glucose tolerance 123 Blood pressure changes 130 Hyponatraemia 134 Hyperprolactinaemia 137 Sexual dysfunction 141 Pneumonia 148 Switching antipsychotics 150 Venous thromboembolism 153 REFRACTORY SCHIZOPHRENIA AND CLOZAPINE 156 Clozapine initiation schedule 156 Optimising clozapine treatment 158 Alternatives to clozapine 162 Re?starting clozapine after a break in treatment 169 Initiation of clozapine for community?based patients 170 CLOZAPINE ADVERSE EFFECTS 175 Clozapine: common adverse effects 175 Clozapine: uncommon or unusual adverse effects 179 Clozapine: serious haematological and cardiovascular adverse effects 184 Clozapine?induced hypersalivation 189 Clozapine?induced gastrointestinal hypomotility (CIGH) 193 Clozapine, neutropenia and lithium 197 Clozapine and chemotherapy 202 Chapter 2 Bipolar disorder 205 Lithium 205 Valproate 214 Carbamazepine 221 Antipsychotic drugs in bipolar disorder 226 Antipsychotic long?acting injections in bipolar disorder 229 Physical monitoring for people with bipolar disorder 232 Treatment of acute mania or hypomania 235 Rapid?cycling bipolar disorder 241 Bipolar depression 243 Prophylaxis in bipolar disorder 250 Chapter 3 Depression and anxiety disorders 255 Depression: introduction 255 Basic principles of prescribing in depression 255 Official guidance on the treatment of depression 256 Antidepressants: general overview 257 Recognised minimum effective doses of antidepressants 262 Drug treatment of depression 264 Treatment of refractory depression: first choice 267 Treatment of refractory depression: second choice 271 Treatment of refractory depression: other reported treatments 274 Psychotic depression 278 Electroconvulsive therapy and psychotropic drugs 281 Stimulants in depression 285 Post?stroke depression 290 Treatment of depression in the elderly 293 Antidepressants: alternative routes of administration 298 Antidepressant prophylaxis 306 Antidepressant discontinuation symptoms 310 Antidepressants: swapping and stopping 314 Drug interactions with antidepressants 321 Cardiac effects of antidepressants 325 Antidepressant?induced arrhythmia 329 Antidepressant?induced hyponatraemia 333 Antidepressants and hyperprolactinaemia 337 Antidepressants and